Effects of a Mindfulness and Acceptance-Based Program on Intimate Relationships in a Youth Sample: A Randomized Controlled Trial

Intimate relationship conflicts in young people are crucial experiences for change. They can lead to more or less satisfactory relationships, depending on individuals’ skills to cope with these conflicts. This may or may not lead to violence in couples. Acceptance and self-regulation processes are an effective strategy to address individual factors such as avoidance and anxiety in intimate relationships of people in these age groups, thus preventing violence. The aim of this study was to assess the effects of an eight-session mindfulness and acceptance-based program (MAP). Participants (n = 40), who were aged from 18 to 25 years old, were randomly assigned to a group receiving the MAP or an active control group. Outcome measures were anxiety about abandonment, intimacy avoidance (Experiences in Close Relationships scale), well-being (Psychological Well-being Scale), dispositional mindfulness (Five Facet Mindfulness Questionnaire) and flexibility (Acceptance and Action Questionnaire-II). Measures were taken at pre-intervention, post-intervention and follow-up. Results showed that the MAP decreased anxiety (p = 0.025) and avoidance (p = 0.01) and increased mindfulness (p < 0.001) and flexibility (p = 0.001). In general, these improvements persisted at follow-up. Results are discussed in relation to the usefulness of mindfulness-acceptance strategies to cope with non-pathological intimate relationship conflicts.

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Effect of a telemedicine intervention for diabetes-related foot ulcers on health, well-being and quality of life: secondary outcomes from a cluster randomized controlled trial (DiaFOTo)

BMC Endocrine Disorders ◽

10.1186/s12902-020-00637-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Marjolein M. Iversen ◽

Jannicke Igland ◽

Hilde Smith-Strøm ◽

Truls Østbye ◽

Grethe S. Tell ◽

...

Keyword(s):

Quality Of Life ◽

Controlled Trial ◽

Foot Ulcer ◽

Well Being ◽

Foot Ulcers ◽

Control Group ◽

Patient Reported ◽

Reported Health

Abstract Background Follow-up care provided via telemedicine (TM) is intended to be a more integrated care pathway to manage diabetes-related foot ulcers (DFU) than traditionally-delivered healthcare. However, knowledge of the effect of TM follow-up on PROMs including self-reported health, well-being and QOL in patients with DFUs is lacking and often neglected in RCT reports in general. Therefore, in this study of secondary outcomes from the DiaFOTo trial, the aim was to compare changes in self-reported health, well-being and QOL between patients with DFUs receiving telemedicine follow-up care in primary healthcare in collaboration with specialist healthcare, and patients receiving standard outpatient care. Methods The current study reports secondary endpoints from a cluster randomized controlled trial whose primary endpoint was ulcer healing time. The trial included 182 adults with diabetes-related foot ulcers (94/88 in the telemedicine/standard care groups) in 42 municipalities/districts, recruited from three clinical sites in Western Norway. Mean (SD) diabetes duration for the study population was 20.8 (15.0). The intervention group received care in the community in collaboration with specialist healthcare using an asynchronous telemedicine intervention. The intervention included an interactive web-based ulcer record and a mobile phone enabling counseling and communication between the community nurses and specialist healthcare; the control group received standard outpatient care. In total 156 participants (78/78) reported on secondary endpoints: self-reported health, well-being and quality of life evaluated by generic and disease-specific patient-reported outcome measures (e.g. Euro-QOL, the Hospital Anxiety and Depression Scale (HADS), Problem Areas in Diabetes (PAID), Neuropathy and Foot Ulcer–Specific Quality of Life Instrument (NeuroQOL)). Linear mixed-effects regression was used to investigate possible differences in changes in the scores between the intervention and control group at the end of follow-up. Results In intention to treat analyses, differences between treatment groups were small and non-significant for the health and well-being scale scores, as well as for diabetes-related distress and foot ulcer-specific quality of life. Conclusions There were no significant differences in changes in scores for the patient reported outcomes between the intervention and control group, indicating that the intervention did not affect the participants’ health, well-being and quality of life. Trial registration Clinicaltrials.gov, NCT01710774. Registered October 19th, 2012.

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Resilience@Work Mindfulness Program: Results From a Cluster Randomized Controlled Trial With First Responders (Preprint)

10.2196/preprints.12894 ◽

2018 ◽

Author(s):

Sadhbh Joyce ◽

Fiona Shand ◽

Tara J Lal ◽

Brendan Mott ◽

Richard A Bryant ◽

...

Keyword(s):

High Risk ◽

Controlled Trial ◽

Intervention Group ◽

First Responders ◽

Well Being ◽

Control Group ◽

Resilience Training ◽

Cluster Randomized ◽

Adaptive Resilience

BACKGROUND A growing body of research suggests that resilience training can play a pivotal role in creating mentally healthy workplaces, particularly with regard to protecting the long-term well-being of workers. Emerging research describes positive outcomes from various types of resilience training programs (RTPs) among different occupational groups. One specific group of workers that may benefit from this form of proactive resilience training is first responders. Given the nature of their work, first responders are frequently exposed to stressful circumstances and potentially traumatic events, which may impact their overall resilience and well-being over time. OBJECTIVE This study aimed to examine whether a mindfulness-based RTP (the Resilience@Work [RAW] Mindfulness Program) delivered via the internet can effectively enhance resilience among a group of high-risk workers. METHODS We conducted a cluster randomized controlled trial (RCT) comprising 24 Primary Fire and Rescue and Hazmat stations within New South Wales. Overall, 12 stations were assigned to the 6-session RAW Mindfulness Program and 12 stations were assigned to the control condition. A total of 143 active full-time firefighters enrolled in the study. Questionnaires were administered at baseline, immediately post training, and at 6-month follow-up. Measurements examined change in both adaptive and bounce-back resilience as well as several secondary outcomes examining resilience resources and acceptance and mindfulness skills. RESULTS Mixed-model repeated measures analysis found that the overall test of group-by-time interaction was significant (P=.008), with the intervention group increasing in adaptive resilience over time. However, no significant differences were found between the intervention group and the control group in terms of change in bounce-back resilience (P=.09). At 6-month follow-up, the group receiving the RAW intervention had an average increase in their resilience score of 1.3, equating to a moderate-to-large effect size compared with the control group of 0.73 (95% CI 0.38-1.06). Per-protocol analysis found that compared with the control group, the greatest improvements in adaptive resilience were observed among those who completed most of the RAW program, that is, 5 to 6 sessions (P=.002). CONCLUSIONS The results of this RCT suggest that mindfulness-based resilience training delivered in an internet format can create improvements in adaptive resilience and related resources among high-risk workers, such as first responders. Despite a number of limitations, the results of this study suggest that the RAW Mindfulness Program is an effective, scalable, and practical means of delivering online resilience training in high-risk workplace settings. To the best of our knowledge, this is the first time a mindfulness-based RTP delivered entirely via the internet has been tested in the workplace. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12615000574549; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368296 (Archived by WebCite at http://www.webcitation.org/75w4xtrpw).

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Efficacy of a Smartphone App Intervention for Reducing Caregiver Stress: Randomized Controlled Trial (Preprint)

10.2196/preprints.17541 ◽

2019 ◽

Author(s):

Matthew Fuller-Tyszkiewicz ◽

Ben Richardson ◽

Keriann Little ◽

Samantha Teague ◽

Linda Hartley-Clark ◽

...

Keyword(s):

Active Control ◽

Psychological Intervention ◽

Controlled Trial ◽

Intervention Group ◽

Well Being ◽

Self Esteem ◽

Mobile App ◽

Control Group ◽

Self Monitoring

BACKGROUND Caregivers play a pivotal role in maintaining an economically viable health care system, yet they are characterized by low levels of psychological well-being and consistently report unmet needs for psychological support. Mobile app–based (mobile health [mHealth]) interventions present a novel approach to both reducing stress and improving well-being. OBJECTIVE This study aims to evaluate the effectiveness of a self-guided mobile app–based psychological intervention for people providing care to family or friends with a physical or mental disability. METHODS In a randomized, single-blind, controlled trial, 183 caregivers recruited through the web were randomly allocated to either an intervention (n=73) or active control (n=110) condition. The intervention app contained treatment modules combining daily self-monitoring with third-wave (mindfulness-based) cognitive-behavioral therapies, whereas the active control app contained only self-monitoring features. Both programs were completed over a 5-week period. It was hypothesized that intervention app exposure would be associated with decreases in depression, anxiety, and stress, and increases in well-being, self-esteem, optimism, primary and secondary control, and social support. Outcomes were assessed at baseline, postintervention, and 3-4 months postintervention. App quality was also assessed. RESULTS In total, 25% (18/73) of the intervention participants were lost to follow-up at 3 months, and 30.9% (34/110) of the participants from the wait-list control group dropped out before the postintervention survey. The intervention group experienced reductions in stress (b=−2.07; P=.04) and depressive symptoms (b=−1.36; P=.05) from baseline to postintervention. These changes were further enhanced from postintervention to follow-up, with the intervention group continuing to report lower levels of depression (b=−1.82; P=.03) and higher levels of emotional well-being (b=6.13; P<.001), optimism (b=0.78; P=.007), self-esteem (b=−0.84; P=.005), support from family (b=2.15; P=.001), support from significant others (b=2.66; P<.001), and subjective well-being (b=4.82; P<.001). On average, participants completed 2.5 (SD 1.05) out of 5 treatment modules. The overall quality of the app was also rated highly, with a mean score of 3.94 out of a maximum score of 5 (SD 0.58). CONCLUSIONS This study demonstrates that mHealth psychological interventions are an effective treatment option for caregivers experiencing high levels of stress. Recommendations for improving mHealth interventions for caregivers include offering flexibility and customization in the treatment design. CLINICALTRIAL Australian New Zealand Clinical Trial Registry ACTRN12616000996460; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371170

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Prevention of Depressive Symptoms and Promotion of Well-being in Adolescents: A Randomized Controlled Trial of the Smile Program

Anales de Psicología ◽

10.6018/analesps.35.2.342591 ◽

2019 ◽

Vol 35 (2) ◽

pp. 300-313

Author(s):

Óscar Sánchez-Hernández ◽

Francisco X. Méndez ◽

Manuel Ato ◽

Judy Garber

Keyword(s):

Depressive Symptoms ◽

Controlled Trial ◽

Intervention Group ◽

Well Being ◽

Behavioral Approach ◽

Control Group ◽

Post Intervention ◽

Post Test ◽

Intervention Condition

This study addressed the development and evaluation of the Smile Program whose main objective was the prevention of depression and the promotion of well-being in adolescents. The program is based on interventions that have been shown to be efficacious (a cognitive-behavioral approach). Participants were 89 adolescents (mean age = 13.88 years; SD = 0.95) recruited from a sample of 1212 students from seven schools. Results showed a significant reduction in self-reported depressive symptoms in the intervention group (n= 51) as compared to youth in the control group (n= 38). Based on parents’ report (n=56), youth in the intervention group had significantly better self-esteem at post-test as compared to youth in the control group. At four months post intervention, youth in the intervention group had higher psychological well-being than those in the control group; at the 8-month follow-up, youth in the intervention condition reported better family self-concept.

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Efficacy of the Digital Therapeutic Mobile App BioBase to Reduce Stress and Improve Mental Well-Being Among University Students: Randomized Controlled Trial (Preprint)

10.2196/preprints.17767 ◽

2020 ◽

Author(s):

Sonia Ponzo ◽

Davide Morelli ◽

Jamie M Kawadler ◽

Nicola Rose Hemmings ◽

Geoffrey Bird ◽

...

Keyword(s):

University Students ◽

Controlled Trial ◽

Well Being ◽

Mobile App ◽

Control Group ◽

Full Time ◽

Digital Version ◽

Sustained Effects ◽

Mental Well Being

BACKGROUND University students in the United Kingdom are experiencing increasing levels of anxiety. A program designed to increase awareness of one’s present levels of well-being and suggest personalized health behaviors may reduce anxiety and improve mental well-being in students. The efficacy of a digital version of such a program, providing biofeedback and therapeutic content based on personalized well-being metrics, is reported here. OBJECTIVE The aim of this study was to test the efficacy and sustained effects of using a mobile app (BioBase) and paired wearable device (BioBeam), compared with a waitlist control group, on anxiety and well-being in university students with elevated levels of anxiety and stress. METHODS The study employed a randomized, waitlist-controlled trial with assessments at baseline, 2 weeks, postintervention (4 weeks), and follow-up (6 weeks). Participants were eligible if they were current full-time undergraduate students and (1) at least 18 years of age, (2) scored >14 points on the Depression, Anxiety, and Stress Scale-21 items (DASS-21) stress subscale or >7 points on the DASS-21 anxiety subscale, (3) owned an iOS mobile phone, (4) did not have any previous psychiatric or neurological conditions, (6) were not pregnant at the time of testing, and (7) were able to read and understand English. Participants were encouraged to use BioBase daily and complete at least one course of therapeutic content. A P value ≤.05 was considered statistically significant. RESULTS We found that a 4-week intervention with the BioBase program significantly reduced anxiety and increased perceived well-being, with sustained effects at a 2-week follow-up. Furthermore, a significant reduction in depression levels was found following the 4-week usage of BioBase. CONCLUSIONS This study shows the efficacy of a biofeedback digital intervention in reducing self-reported anxiety and increasing perceived well-being in UK university students. Results suggest that digital mental health interventions could constitute a novel approach to treat stress and anxiety in students, which could be combined or integrated with existing therapeutic pathways. CLINICALTRIAL Open Science Framework (OSF.io) 2zd45; https://osf.io/2zd45/

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Efficacy of a Smartphone App Intervention for Reducing Caregiver Stress: Randomized Controlled Trial

JMIR Mental Health ◽

10.2196/17541 ◽

2020 ◽

Vol 7 (7) ◽

pp. e17541

Author(s):

Matthew Fuller-Tyszkiewicz ◽

Ben Richardson ◽

Keriann Little ◽

Samantha Teague ◽

Linda Hartley-Clark ◽

...

Keyword(s):

Active Control ◽

Controlled Trial ◽

Intervention Group ◽

Well Being ◽

Self Esteem ◽

Mobile App ◽

Trial Registration ◽

Control Group ◽

Self Monitoring

Background Caregivers play a pivotal role in maintaining an economically viable health care system, yet they are characterized by low levels of psychological well-being and consistently report unmet needs for psychological support. Mobile app–based (mobile health [mHealth]) interventions present a novel approach to both reducing stress and improving well-being. Objective This study aims to evaluate the effectiveness of a self-guided mobile app–based psychological intervention for people providing care to family or friends with a physical or mental disability. Methods In a randomized, single-blind, controlled trial, 183 caregivers recruited through the web were randomly allocated to either an intervention (n=73) or active control (n=110) condition. The intervention app contained treatment modules combining daily self-monitoring with third-wave (mindfulness-based) cognitive-behavioral therapies, whereas the active control app contained only self-monitoring features. Both programs were completed over a 5-week period. It was hypothesized that intervention app exposure would be associated with decreases in depression, anxiety, and stress, and increases in well-being, self-esteem, optimism, primary and secondary control, and social support. Outcomes were assessed at baseline, postintervention, and 3-4 months postintervention. App quality was also assessed. Results In total, 25% (18/73) of the intervention participants were lost to follow-up at 3 months, and 30.9% (34/110) of the participants from the wait-list control group dropped out before the postintervention survey. The intervention group experienced reductions in stress (b=−2.07; P=.04) and depressive symptoms (b=−1.36; P=.05) from baseline to postintervention. These changes were further enhanced from postintervention to follow-up, with the intervention group continuing to report lower levels of depression (b=−1.82; P=.03) and higher levels of emotional well-being (b=6.13; P<.001), optimism (b=0.78; P=.007), self-esteem (b=−0.84; P=.005), support from family (b=2.15; P=.001), support from significant others (b=2.66; P<.001), and subjective well-being (b=4.82; P<.001). On average, participants completed 2.5 (SD 1.05) out of 5 treatment modules. The overall quality of the app was also rated highly, with a mean score of 3.94 out of a maximum score of 5 (SD 0.58). Conclusions This study demonstrates that mHealth psychological interventions are an effective treatment option for caregivers experiencing high levels of stress. Recommendations for improving mHealth interventions for caregivers include offering flexibility and customization in the treatment design. Trial Registration Australian New Zealand Clinical Trial Registry ACTRN12616000996460; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371170

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Does Using Social Network Sites Reduce Depression and Promote Happiness?

International Journal of Technology and Human Interaction ◽

10.4018/ijthi.2020070104 ◽

2020 ◽

Vol 16 (3) ◽

pp. 56-69 ◽

Cited By ~ 1

Author(s):

Sen-Chi Yu

Keyword(s):

College Students ◽

Social Networking ◽

Social Networking Sites ◽

Controlled Trial ◽

Social Network Sites ◽

Well Being ◽

Control Group ◽

Positive Interventions ◽

Randomized Controlled

Positive interventions based on theories in positive psychology have proven effective in contributing to well-being. Although college students frequently use social networking sites, few studies have investigated the use of these sites to facilitate positive interventions. For this research, two positive interventions, photo diaries and the expression of gratitude, were developed and implemented in Facebook using a randomized controlled trial. 136 college students were recruited and randomly assigned them to one of two experimental groups or a control group. Results indicated that photo diary reduced depression during the posttest stage, and these effects continued during the follow up stage. Concerning happiness, the photo diary presented no significant effects in the posttest but did present significant effects in the follow up. Expression of gratitude showed no significant effects on happiness in the posttest but did show significant effects in the follow up. The results of the study demonstrate that social networking sites can be used to implement positive interventions.

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A Multimodal Stress-Prevention Program Supplemented by Telephone-Coaching Sessions to Reduce Perceived Stress among German Farmers: Results from a Randomized Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17249227 ◽

2020 ◽

Vol 17 (24) ◽

pp. 9227

Author(s):

Marita Stier-Jarmer ◽

Cornelia Oberhauser ◽

Dieter Frisch ◽

Götz Berberich ◽

Thomas Loew ◽

...

Keyword(s):

Perceived Stress ◽

Prevention Program ◽

Primary Outcome ◽

Controlled Trial ◽

Well Being ◽

Control Group ◽

Management Intervention ◽

Stress Prevention ◽

Telephone Coaching

This study compared the effectiveness of a 12-day stress-prevention program (SGS) supplemented by individualized, structured, four-session telephone-coaching to that of an SGS without telephone-coaching in entrepreneurs from the green professions presenting with increased stress levels. All participants went through the SGS before being randomized either to the telephone-coaching group (TC) or to the control group without telephone-coaching (noTC). SGS included four key therapeutic elements: stress-management intervention, relaxation, physical exercise, and balneotherapy. The primary outcome was the current degree of subjectively experienced stress assessed with the Perceived Stress Questionnaire (PSQ) at a 9-month follow-up. Secondary outcomes included burnout symptoms, well-being, health status, sleep disorders, expectation of self-efficacy, depression, anxiety, ability to work, pain, and days of sick leave. Assessments were conducted at baseline, 12 days (end of program), and 1 (start telephone-coaching), 3, 6 (end of telephone-coaching), and 9 months. Data from 103 adults (TC = 51; noTC = 52), mostly fulltime farmers, were available for analysis (mean age: 55.3; 49.1% female). Participants experienced significant immediate improvement in all outcome measurements, which declined somewhat during the first three months after the end of SGS and then remained stable for at least another six months. While within-group changes from baseline to 9 months showed significant improvements at medium to large effect sizes for all target variables (PSQ-total, TC: −13.38 (±14.98); 95%-CI: (−17.68; −9.07); noTC: −11.09 (±14.15); 95%-CI: (−15.11; −7.07)), no statistically significant differences were found between the groups at any time and for any target variable (between-group ANCOVA for PSQ-total at 9 months, parameter estimator for the group: −1.58; 95%-CI: (−7.29; 4.13)). The stress-prevention program SGS is a feasible, effective, and practical way to reduce perceived stress and improve participants’ resources. Four subsequent telephone-coaching sessions do not seem to contribute to a further improvement in the results.

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“Being a bully isn’t very cool…”: Rap & Sing Music Therapy for enhanced emotional self-regulation in an adolescent school setting – a randomized controlled trial

Psychology of Music ◽

10.1177/0305735617719154 ◽

2017 ◽

Vol 46 (4) ◽

pp. 568-587 ◽

Cited By ~ 7

Author(s):

Sylka Uhlig ◽

Erik Jansen ◽

Erik Scherder

Keyword(s):

Music Therapy ◽

Promising Result ◽

Therapy Group ◽

Controlled Trial ◽

Self Regulation ◽

School Setting ◽

Well Being ◽

Outcome Data ◽

School Intervention ◽

Control Group

Music as an effective self-regulative tool for emotions and behavioural adaptation for adolescents might enhance emotion-related skills when applied as a therapeutic school intervention. This study investigated Rap & Sing Music Therapy in a school-based programme, to support self-regulative abilities for well-being. One-hundred-and-ninety adolescents in grade 8 of a public school in the Netherlands were randomly assigned to an experimental group involving Rap & Sing Music Therapy or a control group. Both interventions were applied to six classes once a week during four months. Measurements at baseline and again after four months provided outcome data of adolescents’ psychological well-being, self-description, self-esteem and emotion regulation. Significant differences between groups on the SDQ teacher test indicated a stabilized Rap & Sing Music Therapy group, as opposed to increased problems in the control group ( p = .001; ηp2 = .132). Total problem scores of all tests indicated significant improvements in the Rap & Sing Music Therapy group. The RCT results imply overall benefits of Rap & Sing Music Therapy in a school setting. There were improved effects on all measures – as they are in line with school interventions of motivational engagement in behavioural, emotional and social themes – a promising result.

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Effects of smartphone-based stress management on improving work engagement among nurses in Vietnam: a secondary analysis of a three-arm randomized controlled trial (Preprint)

10.2196/preprints.20445 ◽

2020 ◽

Author(s):

Natsu Sasaki ◽

Kotaro Imamura ◽

Thuy Thi Thu Tran ◽

Huong Thanh Nguyen ◽

Kazuto Kuribayashi ◽

...

Keyword(s):

Stress Management ◽

Work Engagement ◽

Controlled Trial ◽

Well Being ◽

Management Program ◽

Control Group ◽

Full Time ◽

Small Effect Size ◽

Stress Management Program

BACKGROUND Work engagement is important for employee’s well-being and work performance. However, no intervention study has investigated the effect of eMental Health intervention on work engagement among workers in low- and middle-income countries (LMICs). OBJECTIVE The aim of the study was to examine the effects of the newly developed smartphone-based stress management program (“ABC stress management”) on improving work engagement among hospital nurses in Vietnam, a LMIC. METHODS Full-time nurses (N= 949) were randomly assigned to two types of intervention groups and a control group. A 6-week, 6-lesson program offering basic cognitive behavioral therapy (CBT-based stress management skills); provided in free-choice (Program A) and fixed order (Program B). Work engagement was assessed at baseline, 3- and 7-month follow-ups in each of the three groups. RESULTS Program B showed a significant intervention effect on improving work engagement at 3-month follow-up (p = 0.049) with a small effect size (Cohen’s d = 0.16). Neither program achieved effectiveness at a 7-month follow-up. CONCLUSIONS The study demonstrated that a smartphone-based stress management program was effective in improving work engagement in nurses in Vietnam, but the effect was small and temporary. This smartphone-based low-cost intervention may improve work engagement for workers in LMICs. CLINICALTRIAL UMIN Clinical Trials Registry (UMIN-CTR) UMIN000033139.

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